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Individual

MRS. JAMIE MOORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
4565 US HIGHWAY 17 STE 200, FLEMING ISLAND, FL 32003-4823
(904) 634-0640
Mailing address
2836 CROSS CREEK DR, GREEN COVE SPRINGS, FL 32043-6234
(904) 505-4840

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 26354
FL

Other

Enumeration date
01/08/2016
Last updated
10/10/2019
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